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Medicare Risk Adjustment Chart Review Jobs (NOW HIRING)

Village Care

Risk Adjustment Coding Manager

Manhattan, NY · On-site

$102K - $115K/yr

Medicare Risk Adjustment Coding Manager Location: Remote (Must Reside in NY/NJ/CT) Work Schedule ... The manager will oversee retrospective and prospective chart review programs while supervising the ...

Village Care

Risk Adjustment Coding Manager

Manhattan, NY · On-site

$102K - $115K/yr

Medicare Risk Adjustment Coding Manager Location: Remote (Must Reside in NY/NJ/CT) Work Schedule ... The manager will oversee retrospective and prospective chart review programs while supervising the ...

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How much do medicare risk adjustment chart review jobs pay per hour?

As of Jun 9, 2026, the average hourly pay for medicare risk adjustment chart review in the United States is $43.31, according to ZipRecruiter salary data. Most workers in this role earn between $31.49 and $53.12 per hour, depending on experience, location, and employer.

What are some common challenges faced in a Medicare Risk Adjustment Chart Review role, and how can they be managed?

A common challenge in Medicare Risk Adjustment Chart Review is ensuring the accuracy and completeness of medical documentation to support proper coding and risk adjustment. Reviewers often encounter incomplete records or ambiguous provider notes, which requires strong attention to detail and effective communication with healthcare staff to clarify information. Staying current with CMS guidelines and coding updates is essential, as regulations and requirements can change frequently. Proactively collaborating with providers and participating in regular training sessions can help manage these challenges and improve review quality.

What is Medicare Risk Adjustment Chart Review?

Medicare Risk Adjustment Chart Review is a process where healthcare professionals review patient medical records to identify and validate diagnoses that impact Medicare Advantage risk scores. This ensures that Medicare Advantage plans receive accurate reimbursement based on the health status and complexity of their enrollees. The review helps to capture any conditions that may not have been coded during patient visits, improving data accuracy and compliance with CMS regulations.

What is the difference between Medicare Risk Adjustment Chart Review vs Medical Coder?

AspectMedicare Risk Adjustment Chart ReviewMedical Coder
Primary FocusReviewing patient charts to ensure accurate risk adjustment data for MedicareAssigning medical codes based on clinical documentation for billing and records
CertificationsOften requires coding certifications and knowledge of Medicare guidelinesCertified Professional Coder (CPC) or equivalent
Work EnvironmentHealthcare facilities, insurance companies, or remoteHospitals, clinics, or billing companies
Industry UsageMedicare Advantage plans, risk adjustment programsMedical billing, coding, and documentation

While both roles involve medical documentation, Medicare Risk Adjustment Chart Review focuses on analyzing charts to optimize Medicare risk scores, whereas Medical Coders assign codes for billing purposes. Understanding these differences helps in choosing the right career path or job focus within healthcare documentation and billing.

What are the key skills and qualifications needed to thrive as a Medicare Risk Adjustment Chart Reviewer, and why are they important?

To thrive as a Medicare Risk Adjustment Chart Reviewer, you need a solid understanding of medical coding (CPT, ICD-10), healthcare compliance, and clinical documentation, often supported by a coding certification such as CPC, CRC, or CCS. Familiarity with electronic medical records (EMRs), risk adjustment software, and auditing tools is typically required. Attention to detail, analytical thinking, and strong communication skills set top performers apart in accurately interpreting and reporting clinical data. These competencies are crucial for ensuring accurate risk adjustment, regulatory compliance, and optimized reimbursement for healthcare organizations.
More about Medicare Risk Adjustment Chart Review jobs
What cities are hiring for Medicare Risk Adjustment Chart Review jobs? Cities with the most Medicare Risk Adjustment Chart Review job openings:
What states have the most Medicare Risk Adjustment Chart Review jobs? States with the most job openings for Medicare Risk Adjustment Chart Review jobs include:
What job categories do people searching Medicare Risk Adjustment Chart Review jobs look for? The top searched job categories for Medicare Risk Adjustment Chart Review jobs are:
Medicare Risk Adjustment Chart Review jobs near you
Infographic showing various Medicare Risk Adjustment Chart Review job openings in the United States as of May 2026, with employment types broken down into 2% Locum Tenens, 15% As Needed, 60% Full Time, 18% Part Time, and 5% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $90,079 per year, or $43.3 per hour.
Risk Adjustment Coding Manager

Risk Adjustment Coding Manager

Village Care

Manhattan, NY • On-site

$102K - $115K/yr

Full-time

Posted 20 days ago

Job description

Position: Medicare Risk Adjustment Coding Manager
Location: Remote (Must Reside in NY/NJ/CT)
Work Schedule: Monday - Friday, 9:00am - 5:00pm
Compensation: $102,549.17 - $115.367.82 Annual Salary
Join VillageCare as a Full-Time Medicare Risk Adjustment Coding Manager and enjoy the thrill of playing a vital role in healthcare's future while working from the comfort of your home. This position offers unparalleled flexibility, allowing you to balance personal and professional commitments seamlessly. Envision being part of a team that prioritizes excellence and customer-centric solutions in the ever-evolving health care landscape, all while residing in the vibrant city of New York, NY. As a key player in our organization, you will lead initiatives that directly impact patient care and financial outcomes. The compensation for this role ranges from $102,549.17 to $115,367.82, reflecting the importance we place on your expertise and leadership.
If you are a smart problem solver with a passion for integrity and high-performance culture, consider applying to be a part of our forward-thinking team.
VillageCare: Our Mission
VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years.
Are you excited about this Medicare Risk Adjustment Coding Manager job?
The Risk Adjustment Coding Manager at VillageCare plays a crucial role in enhancing healthcare quality and operational efficiency. This position is responsible for coordinating Risk Adjustment and Quality coding operations, emphasizing documentation integrity across both areas. The manager will oversee retrospective and prospective chart review programs while supervising the Risk Adjustment coding staff and managing day-to-day vendor operations. Acting as the operational bridge between Risk Adjustment and the HEDIS/Quality abstraction team, the manager ensures that all medical record interactions are utilized effectively for Hierarchical Condition Category (HCC) accuracy and closing quality gaps.
By eliminating redundant provider outreach and maximizing the clinical value of each chart interaction, this role aims to achieve year-over-year improvements in Risk Adjustment accuracy, Risk Adjustment Factor (RAF) performance, and STARs quality measure outcomes, directly impacting patient care and organizational success.
Requirements for this Medicare Risk Adjustment Coding Manager job
To excel as the Risk Adjustment Coding Manager at VillageCare, candidates must possess a robust set of skills and qualifications. A CPC, CPMA, CRC, CCS-P, CCS, RHIA, or RHIT certification is essential, along with at least five years of experience in Medicare Risk Adjustment coding and familiarity with RADV audits. Proficiency in HEDIS measure specifications and quality gap closure operations is highly preferred. Candidates should have a strong command of ICD-10 and CPT codes, as well as experience using electronic medical record systems.
Excellent communication skills are vital for effectively collaborating within the department and with cross-functional teams. Additionally, a Bachelor's degree in Business Administration, Finance, or a relevant field, or equivalent work experience, is required, ensuring that the candidate is well-equipped to navigate the complexities of healthcare coding and operational management.
Knowledge and skills required for the position are:
  • CPC /CPMA/ CRC/ CCS-P/ CCS/ RHIA or RHIT certification.
  • Experience with HEDIS measure specifications and quality gap closure operations preferred
  • 5+ years of Medicare Risk Adjustment coding including work on RADV audits
  • Previous experience using electronic medical record systems.
  • Strong knowledge of ICD-10 and CPT codes
  • Excellent communication skills to facilitate working with teammates within the department and cross-functional teams.
  • Bachelor's degree in Business Administration, Finance or relevant field OR equivalent work experience required
Are you ready for an exciting opportunity?
If you have these qualities and meet the basic job requirements, we'd love to have you on our team. Apply now using our online application!

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